The Boston Globe on the Massachusetts Death with Dignity Initiative

Last Sunday, the Boston Globe Magazine helped many Bay Staters learn more about the proposed Death with Dignity Act in Massachusetts. The magazine’s feature, “Dying wishes”, by Scott Helman contains a personal story about why two Massachusetts advocates are volunteering their time in support of the ballot measure, outlines the facts of the measure, and highlights the history of Death with Dignity laws in other states.

Perhaps the most touching story from the article is that of Heather Clish. When her parents were visiting Heather in Massachusetts, her father was diagnosed with a terminal brain tumor—the same type of cancer Senator Ted Kennedy had. An Oregonian, Heather’s father knew of his state’s Death with Dignity Act, and chose to request the prescribed medication while he received palliative care and his family enrolled him in hospice care.

When his pain and suffering became too great for the doctors to relieve, he decided to take the medication. Heather and her sisters were able to travel to Oregon to be with her dad in his final moments:

Clish and her two sisters filled his ears with pleasant images. Mary Lou lay in his arms, as he’d wanted. He had earlier told her, “I hope I will be holding you when I take my last breath.” Johnson slipped into what looked like a deep sleep. After about 15 minutes, his pulse stopped.

Massachusetts’ proposed law emulates the time-tested and safe Oregon and Washington laws. All too often, inaccuracies are put forth about Death with Dignity Acts, but to reduce confusion, Helman does an outstanding job of explaining the facts about law:

Under the Massachusetts proposal, which is virtually identical to the laws in Oregon and Washington, terminally ill, mentally competent adults deemed to have six months or less to live would have the freedom to obtain a fatal prescription. They could qualify only after going through a process designed to ensure that they are not being coerced and that they fully understand what they’re doing. They would administer the drugs themselves. Any doctor opposed to the practice could opt out of writing the prescription.

In recapping the long history of Oregon’s law—which went into effect in 1997—and the extensive research that’s been done over the years. An especially poignant paragraph demonstrates that even researchers opposed to the Death with Dignity Act have found concerns about the law unfounded:

Even some personally opposed to assisted suicide agree Oregon has proved many of the concerns to be overblown. “When all things are considered, the arguments in favor of continued prohibition of physician-assisted suicide are not particularly compelling,” Daniel E. Lee, an ethicist and professor at Augustana College in Rock Island, Illinois, wrote in a 2003 essay for the Hastings Center Report, a prominent ethics journal. Lee wrote that it’s perfectly appropriate to maintain moral reservations, as he does. But he said that was not enough to “stand in the way” of those who want to make a different choice.

Included in the article is the perspective of another prominent supporter of Massachusetts’ efforts, Dr. Marcia Angell, former editor of the New England Journal of Medicine and senior lecturer at the Harvard Medical School. Her father suffered greatly with incurable prostate cancer, and killed himself. Dr. Angell firmly believes her father would have wanted the option, and all terminally ill individuals should be able to decide when or whether to shorten their suffering as death draws near:

Is ingesting a lethal prescription morally distinct from removing a ventilator or a feeding tube? Terminally ill patients and their proxies make those decisions every day.

Doctors can’t always alleviate suffering for the dying, she says, and patients should have the option to end it themselves. That, she argues, is consistent with the greatest obligation of doctors—to care for people as best they can, in accordance with their wishes.

Besides, Angell argues, top-flight end-of-life care and the choice of taking a lethal drug can coexist. “Good comfort care and the availability of physician-assisted suicide are no more mutually exclusive than good cardiologic care and the availability of heart transplantation,” Angell wrote in a 1997 Journal editorial. In fact, studies suggest that Oregon’s Death with Dignity Act has only improved end-of-life care in the state.

Heather Clish, drawing from her experience with her father’s peaceful death explained why this should be an option in every state:

This is not a choice that is right for everybody. But for each of the people who have chosen it, no matter how small the number, it is of immeasurable value.